Bipolar disorder is a mental illness that varies from severe and long-term, or mild with infrequent episodes. The typical patient with bipolar disorder averages 8 - 10 manic or depressive episodes over a lifetime. Some people experience more and some fewer episodes.
Research shows that bipolar disorder patients have higher death rates from suicide, diabetes and heart problems than those in the general population. Patients who get treatment experience great improvement in survival rates.
Usually the depressive phases are more than manic phases, and the cycles of mania and depression are irregular and unpredictable. Many patients experience mixed mania, or a mixed state, in which both mania and depression coexist daily.
A smaller percentage of Bipolar patients have episodes known as rapid cycling. With this phase the manic and depressive episodes alternate at least four times a year and, in severe cases, can even progress to several cycles a day. Rapid cycling tends to occur more often in women and in those with Bipolar II. This type of the disorder is difficult to treat since the use of antidepressants can trigger the switch to mania.
Symptoms of bipolar disorder in children and adolescents are different than those of adults. Mania in children is characterized by irritability. Children with bipolar depression are angry and restless, and may have mood and behavioral disorders such as anxiety, attention deficit hyperactivity disorder, conduct disorder. It is still unknown if childhood bipolar disorder persists into adulthood.
The prognosis for Bipolar disorder depends on the person it must be managed carefully at all times. Episodes of mania and depression may recur throughout the person's life but with treatment the severity and duration of episodes can be reduced. Early treatment is always more effective than treatment later in an episode. A small number of people are resistant to all treatment. People with Bipolar II generally have a better prognosis than those with Bipolar I.
Factors considered important in determining the prognosis of patients with bipolar disorder include the time between the onset of the symptoms and the beginning of drug therapy, presence or absence of psychotic features, indications of rapid-cycling, and presence of risk factors such as drug or alcohol dependency.
People with bipolar disorder can lead a healthy and productive life with treatment and compliance with the treatment program. Without treatment, bipolar disorder worsens with more frequent episodes of mania and depression which become more severe and intense. Drugs and psychotherapy are the most effective treatments. Medications may need to be adjusted in some people more frequently than in others. Patients need to be vigilant for early warning signs of relapse and seeking help as quickly as possible.
